Anastomosis devices

Abstract

An implantable medical device for connecting tissue layers, such as connecting tubular tissues to create an anastomosis, includes a single elongate member and a covering material. The devices provided may also be used for other purposes including, but not limited to, partially or fully occluding openings in tissue, temporarily or permanently holding generally planar layers of tissue together, aneurysm repair, and the like.

What is claimed is: 
     
         1 . A medical device for creating an anastomosis between a first body conduit and a second body conduit, the device comprising:
 a frame comprising an elongate member, the elongate member defining:
 a first apposition portion including a first looped feature, the first apposition portion configured to conform to a geometry of a first tissue surface of the first body conduit and to provide an apposition force against the first tissue surface; 
 a second apposition portion including a second looped feature, the second apposition portion configured to conform to a geometry of a second tissue surface of the second body conduit and to provide an apposition force against the second tissue surface; and 
 a central portion disposed between the first apposition portion and the second apposition portion, wherein the elongate member traverses the central portion in a helical pattern a plurality of times such that the central portion is longitudinally extendable from a contracted configuration to an expanded configuration and the central portion defines a lumen therethrough. 
   
     
     
         2 . The device of  claim 1 , wherein the elongate member is wound in a winding pattern where (1) the elongate member defines the first looped feature, (2) the elongate member traverses the central portion along a helical path, (3) the elongate member defines the second looped feature, and (4) the elongate member traverses the central portion along a helical path, and
 wherein the elongate member repeats the winding pattern such that a plurality of first looped features and a plurality of second looped features are formed.   
     
     
         3 . The device of  claim 2 , wherein the first apposition portion includes the plurality of first looped features and wherein the second apposition portion includes the plurality of second looped features. 
     
     
         4 . The device of  claim 3 , wherein the plurality of first looped features are offset from the plurality of second looped features. 
     
     
         5 . The device of  claim 3 , wherein the plurality of first looped features include one or more first elongate wire loops, and wherein each of the one or more first elongate wire loops is configured to independently bear a load associated with the first tissue surface relative to the other of the one or more first elongate wire loops. 
     
     
         6 . The device of  claim 5 , wherein the plurality of second looped features include one or more second elongate wire loops, and wherein each of the one or more second elongate wire loops is configured to independently bear a load associated with the second tissue surface relative to the other of the one or more second elongate wire loops. 
     
     
         7 . The device of  claim 1 , wherein portions of the elongate member in the central portion are substantially perpendicular to a longitudinal axis of the frame when the frame is in the contracted configuration. 
     
     
         8 . The device of  claim 7 , wherein the frame is configured to move from the contracted configuration toward the expanded configuration with corresponding movement of the elongate member in the central portion resulting in a greater longitudinal extension of the frame than a reduction in a diameter of the central portion. 
     
     
         9 . The device of  claim 1 , wherein the elongate member is a single elongate member. 
     
     
         10 . The device of  claim 9 , wherein the single elongate member traverses the central portion along a path comprising a segment of a helix. 
     
     
         11 . The device of  claim 9 , wherein the single elongate member has a defined length and has a variable thickness throughout said the defined length. 
     
     
         12 . The device of  claim 1 , wherein the elongate member comprises a nitinol wire. 
     
     
         13 . The device of  claim 1 , further including a covering material positioned around the central portion of the medical device. 
     
     
         14 . The device of  claim 13 , wherein the covering material is configured to inhibit tissue ingrowth and/or endothelialization into the covering material. 
     
     
         15 . The device of  claim 13 , wherein the covering material is also disposed on at least a portion of the first apposition portion and/or the second apposition portion. 
     
     
         16 . The device of  claim 13 , wherein the covering material comprises expanded polytetrafluoroethylene (ePTFE). 
     
     
         17 . The device of  claim 1 , further comprising one or more radiopaque markers disposed on the device. 
     
     
         18 . The device of  claim 1 , wherein the frame further comprises one or more tissue anchorage features. 
     
     
         19 . The device of  claim 1 , wherein a diameter of the central portion is substantially the same in the contracted configuration and the expanded configuration. 
     
     
         20 . A medical device for creating an anastomosis between a first body conduit and a second body conduit, the device comprising:
 a frame being formed by an elongate member, the elongate member defining:
 a first apposition portion including a plurality of first wire loops configured to conform to a geometry of a first tissue surface of the first body conduit and to provide an apposition force against the first tissue surface; 
 a second apposition portion including a plurality of second wire loops configured to conform to a geometry of a second tissue surface of the second body conduit and to provide an apposition force against the second tissue surface; and 
 a central portion disposed between the first apposition portion and the second apposition portion, the central portion defining a lumen therethrough; and 
   wherein the elongate member forms a first individual wire loop of the first wire loops of the first apposition portion, traverses the central portion along a helical path in a direction away from the first apposition portion and toward the second apposition portion, forms a second individual wire loop of the second wire loops of the second apposition portion, traverses the central portion along a helical path in a direction away from the second apposition portion and toward the first apposition portion, and repeats a pattern thereby such that the plurality of the first wire loops of the first apposition portion and the plurality of the second wire loops of the second apposition portion are formed.   
     
     
         21 . The medical device of  claim 21 , wherein the central portion is formed of a plurality of segments which combine to define a helix. 
     
     
         22 . The medical device of  claim 21 , further comprising a covering material disposed on at least a portion of the central portion, the covering material configured to allow material flow through the lumen and between the first body conduit and the second body conduit. 
     
     
         23 . The medical device of  claim 21 , wherein the elongate member comprises nitinol. 
     
     
         24 . The medical device of  claim 21 , wherein the frame has a contracted configuration and an expanded configuration, and
 wherein portions of the elongate member in the central portion are perpendicular to a longitudinal axis of the frame when the frame moves from the contracted configuration to the expanded configuration.   
     
     
         25 . The medical device of  claim 21 , wherein the elongate member is a single wire. 
     
     
         26 . The medical device of  claim 25 , wherein the single wire has a defined length and has a variable thickness throughout the length. 
     
     
         27 . The medical device of  claim 21 , wherein the plurality of first wire loops of the first apposition portion are offset from the plurality of second wire loops of the second apposition portion. 
     
     
         28 . The medical device of  claim 21 , wherein the elongate member comprises two free ends, and the two free ends are conjoined such that the elongate member forms a continuous loop. 
     
     
         29 . A medical device for creating an anastomosis between a first body conduit and a second body conduit, the device comprising:
 a first apposition portion including at least one first wire loop configured to conform to a geometry of a first tissue surface of the first body conduit and to provide an apposition force against the first tissue surface;   a second apposition portion including at least one second wire loop configured to conform to a geometry of a second tissue surface of the second body conduit and to provide an apposition force against the second tissue surface; and   a central portion disposed between the first apposition portion and the second apposition portion, the central portion defining a lumen therethrough, the central portion formed of more than one segment which, when combined together, define a helix,   wherein the central portion is defined by a single elongate member traversing the central portion a plurality of times to form the helix.   
     
     
         30 . The medical device of  claim 29 , wherein the device includes a contracted configuration and an expanded configuration. 
     
     
         31 . The medical device of  claim 30 , wherein the central portion includes:
 a first length in the contracted configuration, the first length defined by a first distance between the first apposition portion and the second apposition portion; and   a second length in the expanded configuration, the second length defined by a second distance between the first apposition portion and the second apposition portion.   
     
     
         32 . The medical device of  claim 31 , wherein the second length is greater than the first length. 
     
     
         33 . The medical device of  claim 31 , wherein a diameter of the central portion is substantially the same in the contracted configuration and the expanded configuration, the diameter being substantially consistent along the first length in the contracted configuration and the second length in the expanded configuration. 
     
     
         34 . The medical device of  claim 29 , wherein the single elongate member also forms the first apposition portion and the second apposition portion by traversing the central portion a plurality of times. 
     
     
         35 . The medical device of  claim 29 , wherein the single elongate member comprises a single nitinol wire.